Epidemiology, Vascular Pathophysiology, and Metabolic Syndrome: Key Concepts and Mechanisms

What characterizes the epidemiological transition?

Shift toward chronic, degenerative diseases due to increased lifespan

What factor most strongly drives modern chronic disease prevalence?

Long-term system dysregulation

What does endothelial dysfunction most directly result in?

Increased lipid infiltration and inflammation

What is the earliest detectable lesion in atherosclerosis?

Fatty streak

How does oxidized LDL contribute to plaque formation?

Activating macrophages

Foam cells are formed from what?

Macrophages ingesting oxidized LDL

Which condition accelerates endothelial damage most significantly?

Chronic hypertension

What best describes the role of smooth muscle cells in plaque formation?

Form fibrous cap

What does plaque rupture lead to?

Thrombosis

Which system primarily increases vascular resistance?

RAAS

How does angiotensin II increase blood pressure?

Vasoconstriction and aldosterone release

How does aldosterone increase blood pressure?

Retaining sodium and water

How do ACE inhibitors lower blood pressure?

Blocking angiotensin II formation

What does chronic RAAS activation contribute to?

Hypertension

What best explains age-related hypertension?

Arterial stiffening

Which hormone primarily increases blood glucose during stress?

Cortisol

What does chronic cortisol elevation lead to?

Insulin resistance

What best describes insulin resistance?

Reduced cellular response to insulin

What metabolic change defines metabolic syndrome?

Insulin resistance

Which lipid profile is most atherogenic?

High LDL, low HDL

How does chronic hyperglycemia damage vessels?

Glycation and oxidative stress

What process produces advanced glycation end products?

Protein-glucose interaction

What factor increases peripheral resistance?

Vasoconstriction

How is cardiac output defined?

Heart rate × stroke volume

What increases cardiac output?

Increased stroke volume

What contributes most to abdominal fat accumulation?

Chronic stress

How does the microbiome influence metabolism?

Extracting energy from food

What is obesity associated with?

Reduced microbial diversity

What does a core microbiome refer to?

Same functional genes across individuals

What best explains microbiome-metabolism interaction?

Two-way interaction

Which hormone lowers blood glucose?

Insulin

Which hormone raises blood glucose?

Glucagon

Which hormone increases immediate stress response?

Epinephrine

Which hormone increases long-term stress response?

Cortisol

Which hormone increases water retention?

ADH

Which hormone increases sodium retention?

Aldosterone

What triggers renin release?

Low BP

Which organ produces angiotensinogen?

Liver

Which enzyme converts angiotensin I to II?

ACE

What increases sympathetic tone?

Stress

What increases plaque instability?

Inflammation

What reduces plaque formation?

High HDL

What increases vessel stiffness?

Aging

What increases insulin resistance?

Chronic stress

What decreases insulin sensitivity?

Obesity

What increases inflammation?

Oxidized LDL

What contributes to fatty streaks?

Foam cells

What increases BP fastest?

Vasoconstriction

What increases blood volume?

Sodium retention

What increases glucose production?

Cortisol

What decreases BP?

ACE inhibition

What reduces LDL?

Statins

What improves insulin sensitivity?

Exercise

What reduces inflammation?

Lifestyle change

What reduces plaque risk?

Lower LDL

What increases metabolic syndrome risk?

Sedentary lifestyle

What increases microbiome diversity?

High fiber diet

What decreases microbiome diversity?

Obesity

What increases energy extraction?

Certain microbiome compositions

What links stress to disease?

Chronic stress response

What is the HPA axis?

A stress pathway involving hypothalamus, pituitary, and adrenal glands producing cortisol

How does the microbiome affect metabolism?

It regulates energy extraction from food

What happens to microbiome diversity in obesity?

It decreases

What is a core microbiome?

Shared functional genes across individuals

What best describes microbiome-metabolism interaction?

A two-way relationship

What hormone lowers blood glucose?

Insulin

What hormone raises blood glucose?

Glucagon

What hormone drives immediate stress response?

Epinephrine

What hormone drives long-term stress response?

Cortisol

What hormone increases water retention?

ADH

What hormone increases sodium retention?

Aldosterone

What enzyme produces angiotensin II?

ACE

What increases inflammation in arteries?

Oxidized LDL

What contributes to fatty streak formation?

Foam cells

What increases energy extraction from food?

Certain microbiome compositions

Does chronic stress decrease BP?

No

Does HDL promote plaque formation?

No

Does RAAS increase BP?

Yes

Does aging reduce arterial stiffness?

No

Does obesity increase inflammation?

Yes

Does insulin lower blood glucose?

Yes

Does glucagon lower blood glucose?

No

Can plaque rupture cause thrombosis?

Yes

Does LDL remove cholesterol?

No

Does cortisol increase glucose?

Yes

Does microbiome affect metabolism?

Yes

Does RAAS decrease blood volume?

No

Does hypertension damage vessels?

Yes

Does hyperglycemia damage endothelium?

Yes

Does exercise improve insulin sensitivity?

Yes

Do statins increase LDL?

No

Do ACE inhibitors reduce BP?

Yes

Does stress increase cortisol?

Yes

Does metabolic syndrome include low HDL?

Yes

Does chronic inflammation stabilize plaques?

No

How does RAAS increase BP mechanistically?

It produces angiotensin II, causing vasoconstriction and stimulating aldosterone and ADH, increasing blood volume and resistance

How does hypertension lead to plaque formation?

It damages endothelium, allowing lipid infiltration and inflammation

How does insulin resistance develop?

Chronic high glucose and fat accumulation reduce cellular response to insulin

How does microbiome influence obesity?

It alters energy extraction and fat storage

What is endothelial dysfunction?

Increased permeability and inflammation in vessel lining